目的:胎儿和新生儿尸检为生殖医学中的疾病过程和临床决策提供了重要的见解。阐明死亡原因并更深入地了解导致胎儿死亡的实体有助于医生和患者的预期指导。准确评估胎儿的生长和约会是对胎儿和新生儿人群进行病理分类的重要方面。本研究旨在优化尸检方法,以确定大小和年代差异,除了探索死产原因的当前趋势,关于胎盘,胎儿/新生儿,和母亲因素,以及尸检后仍未确定的病例率。
方法:对2008年年中至2021年的尸检报告进行的单机构回顾性审查显示,有243项完整的围产期尸检检查。
结果:在46%的病例中发现了胎盘死亡的原因。在22%的病例中,死亡原因尚未确定。在几乎一半的死亡原因未确定的病例中,对一个病例子集的评估几乎没有报告大小和/或日期差异。
结论:“最佳实践”建议在死后确定胎儿/新生儿的大小和日期,以帮助提供明确的,一致的报告。因为胎儿和新生儿尸检是了解导致死产的因素的宝贵工具,重要的是使用适当的大小和约会方法以及一致的语言来提供适当的患者教育和临床指导。
OBJECTIVE: Fetal and neonatal autopsy offers critical insight into disease processes and clinical decision-making in reproductive medicine. Elucidating the cause of death and gaining a deeper understanding of the entities leading to fetal demise aids in anticipatory guidance for physicians and patients. Accurate assessment of growth and dating of fetuses is an important aspect of classifying pathology in the fetal and neonatal population. This study aims to optimize the autopsy approach to sizing and dating discrepancies, in addition to exploring the current trends in causes of stillbirth, with respect to placental, fetal/neonatal, and maternal factors, and rates of cases that remain undetermined after autopsy.
METHODS: A single-institution retrospective review of autopsy reports from mid-2008 through 2021 revealed 243 complete perinatal autopsy examinations.
RESULTS: Placental cause of demise was identified in 46% of cases. Cause of demise was undetermined in 22% of cases. Evaluation of a subset of cases exposed minimal to no reporting of size and/or dating discrepancies in almost half of cases with undetermined cause of death.
CONCLUSIONS: \"Best practice\" suggestions for sizing and dating fetuses/neonates in the postmortem period have been developed to aid in delivering clear, consistent reports. Because fetal and neonatal autopsy is an invaluable tool for understanding the factors that contribute to stillbirth, it is important to use appropriate sizing and dating methods and consistent language to deliver proper patient education and clinical guidance.